PECOS Enrollment for Dentists

New Medicare regulations affect many referring dentists who are not enrolled in the Provider Enrollment, Chain and Ownership System (PECOS). The Affordable Care Act of 2010 stipulated that any provider who refers or orders covered services for Medicare beneficiaries must be enrolled in PECOS by January 3, 2011. Dentists, including oral surgeons, must enroll in the Medicare program to receive reimbursement for services furnished to Medicare beneficiaries or to order covered services for Medicare beneficiaries. The original article stated that, without a PECOS provider number, no services related to referral of Medicare patients to any provider would be reimbursed.

Realizing that most dentists have no desire to participate, Medicare has provided an option for dentists to enroll as “referring and ordering providers only” as a method of obtaining a PECOS provider number. Enrolling in this way means that the dentists would NOT be enrolled for the purpose of providing Medicare services themselves.

On November 26, 2010, CMMS revised the original edit on referring/ordering providers in Medicare Part B, postponing the implementation of non-payment due to application backlogs. This is welcome news for both providers and beneficiaries and provides additional time for the completion of PECOS enrollment. Furthermore, CMMS promised to provide ample notice before initiating non-payment action.

The completion of applications and submission of needed documents to enroll in Medicare is an arduous and ever changing process. A+ credentialing specialists work with our clients who are dentists to obtain a PECOS enrollment record as a “referring and ordering provider only”. Take advantage of the reprieve in the deadline. Contact us now to start the process!